Sunday, November 16, 2008

Is "New" Autism Theory Much Ado About Nothing?

I have read the New York Times article In a Novel Theory of Mental Disorders, Parents’ Genes Are in Competition about the new theory articulated by Dr Crespi and Dr Badcock but I have to confess that I do not see what all the fuss is about. From what this humble layman can understood the "theory" is really little more than speculation, a simple reorganization of how we categorize or arrange various discrete disorders. It does not appear to be based on any novel research, evidence or observations.

I am not sure if it is properly called a theory but the NYT summarizes it as follows:

Their idea is, in broad outline, straightforward. Dr. Crespi and Dr. Badcock propose that an evolutionary tug of war between genes from the father’s sperm and the mother’s egg can, in effect, tip brain development in one of two ways. A strong bias toward the father pushes a developing brain along the autistic spectrum, toward a fascination with objects, patterns, mechanical systems, at the expense of social development. A bias toward the mother moves the growing brain along what the researchers call the psychotic spectrum, toward hypersensitivity to mood, their own and others’. This, according to the theory, increases a child’s risk of developing schizophrenia later on, as well as mood problems like bipolar disorder and depression.

In short: autism and schizophrenia represent opposite ends of a spectrum that includes most, if not all, psychiatric and developmental brain disorders. The theory has no use for psychiatry’s many separate categories for disorders, and it would give genetic findings an entirely new dimension.

What is meant by the NYT 's expressions "tug of war" and "bias"? How do these events occur? And why does the theory have no use for psychiatry's many separate categories for disorders? If persons now described as having schizophrenia, bi-polar disorder or autism consistently exhibit different behaviors and different ways of thinking or understanding the world why should the categories be disregarded?

One of the authors of the theory, Dr. Crespi, states that the implications of their theory are huge.

This humble father of a 12 year old boy with Autistic Disorder, and profound developmental delays, is not so sure.

6 comments:

There is a legend in Eastern Europe saying that, while the Turks were launching their final assault upon the great city of Constantinople, the greek theologians of the day fiercely debated, behind the city walls, whether angels do have a sex and if so, which one is it?

Autism and schizophrenia may or may not be part of the same spectrum. This doesn't change the reality that many young children get diagnosed with autism every single year and for many of them the perspectives are not at all good.

I would not describe their new theory as autism and schizophrenia being part of the same spectrum. Instead, their theory is that "normal" is in the middle and autism is in one direction away from normal and schizophrenia is in the opposite direction away from normal. One implication is that persons with autism are unlikely to develop schizophrenia, even though as adults the outward appearance may seem similar. One step further might be that adults who originally were diagnosed as having schizophrenia but now claim they are on the autism spectrum might really have schizophrenia and not at all autism because they are diametrical according to this new theory. It is possible I seriously misunderstand their theory and its implications.

101 Noteworthy Sites on Asperger's & Autism Spectrum Disorders

Facing Autism on Facebook

Why ABA For Autism?

The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–4American Academy of Pediatrics, Management of Children with Autism Spectrum Disorders

"We have to look also at environmental factors, and from my point of view, the interaction between the genetic factors and the environmental factors ... It looks like some shared environmental factors play a role in autism, and the study really points toward factors that are early in life that affect the development of the child"
Joachim Hallmayer, MD, associate professor of psychiatry at Stanford University in California

Even Out Environmental and Genetic Autism Research Funding

Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones.

We need to even out the funding.

Irva Hertz-Picciotto, UC Davis M.I.N.D. Institute Researcher

My Autism Pledge For Conor

Today I pledge to continue;I Pledge to continue to fight for the availability of effective autism treatments;I Pledge to continue to fight for a real education for autistic children;I Pledge to continue to fight for decent residential care for autistic adults;I Pledge to continue to fight for a cure for autism;I Pledge to continue finding joy in my son but not in the autism disorder that restricts his life;Today, and every day, I Pledge to continue to hope for a better life for Conor and others with autism, through accommodation, care, respect, treatment, and some day, a cure;Today, and every day, I Pledge to continue to fight for the best possible life for Conor, my son with autistic disorder.

Dr. Jon Poling : Blinders Won’t Reduce Autism

"Fortunately, the ‘better diagnosis’ myth has been soundly debunked. ... only a smaller percentage of this staggering rise can be explained by means other than a true increase.

Because purely genetic diseases do not rise precipitously, the corollary to a true autism increase is clear — genes only load the gun and it is the environment that pulls the trigger. Autism is best redefined as an environmental disease with genetic susceptibilities."

We should be investing our research dollars into discovering environmental factors that we can change, not more poorly targeted genetic studies that offer no hope of early intervention. Pesticides, mercury, aluminum, several drugs, dietary factors, infectious agents and yes — vaccines — are all in the research agenda.